| NPI | 1750843579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist Pharmacotherapy (Licence: ID P8068) |
| Additional Taxonomies | 1835P2201X Pharmacist Ambulatory Care (Licence: ID P8068) |
| 1835P1200X Pharmacist Pharmacotherapy (Licence: OR RPH-0019401) | |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2023-04-12 |